S. African president denies AIDS emergency

Crisis fails to meet legal test, he says

cheap drugs rejected

March 15, 2001|By John Murphy | John Murphy,SUN FOREIGN STAFF

JOHANNESBURG, South Africa - South African President Thabo Mbeki rejected calls to declare the spread of AIDS a national emergency yesterday, a move that would have given the country access to cheap generic drugs to fight the disease.

More than 4 million people in South Africa, 10 percent of the population, have the virus that causes AIDS. The demand for an emergency declaration came from members of South Africa's main opposition party, which has criticized the government for failing to do more to counter the country's health crisis.

The proposal had also won support from South Africa's largest labor federation, an ally of the ruling African National Congress.

Rules of the World Trade Organization allow countries faced with a national health emergency to bypass drug patents and buy inexpensive copies of brand-name drugs or produce them domestically.

In South Africa's case, an emergency declaration would allow the country to take advantage of an Indian pharmaceutical company's offer to sell a potent combination of AIDS drugs for about $350 a year for each patient.

Patients in developed countries pay $10,000 to $15,000 per year for the same medicines.

But Mbeki said the country's AIDS crisis did not meet the standards for a national emergency. South African law, the president said, allows the declaration of an emergency only "when the life of a nation is threatened by war, invasion, general insurrection, disorder, natural disaster or other public emergency," and then only when the declaration is necessary to restore peace and order.

Both of the conditions must be met to declare an emergency and, even then, the declaration would be effective for only 21 days unless parliament voted to extend it.

"We believe that such a declaration is a drastic measure which entails the curtailment of the provisions of the Bill of Rights," Mbeki said during a nationally televised question and answer session before the South African National Assembly.

"It has other complex consequences for the country which are undesirable, especially when there are other ways to achieve the same objective, that is, obtaining affordable access to all medicines."

He insisted that the country would win access to affordable medicines by relying on a law passed in 1997 giving the government authority to import or produce drugs to treat many ailments.

That law, however, is being contested in South African courts by the world's pharmaceutical giants, which argue that it violates international law by threatening their intellectual property rights. That trial began last week but was quickly adjourned; it is scheduled to reconvene next month.

Mbeki's comments yesterday marked the first time in months the president has publicly discussed the country's AIDS crisis. Last year, Mbeki drew criticism from doctors and AIDS activists when he questioned whether the human immunodeficiency virus actually causes AIDS.

After battling criticism for much of the year, Mbeki bowed out of the AIDS debate in October by saying he would leave the matter to his minister of health and other specialists.

But by posing the question of a national emergency, the country's main opposition party looked to draw Mbeki back into the fray.

"Last year an estimated 250,000 South Africans died of AIDS," Tony Leon, leader of the Democratic Alliance party, said in parliament. "It's estimated that more than 4 million South Africans are sick or dying of AIDS at the moment. And if that isn't an emergency, sir, it's difficult to know what is."

South Africa's 4 million people infected with HIV account for nearly 20 percent of the adult population. In neighboring Zimbabwe, the infection rate among adults has reached 25 percent; in the United States and Canada, the infection rate is less than 1 percent, according to the United Nations World Health Organization. About 95 percent of the known cases of HIV/AIDS are in the developing world.

Mbeki said the government was doing enough to fight AIDS. He said he would await the court's decision on the disputed law and the report of a presidential advisory team on AIDS before changing government policies.

Even if cheaper AIDS drugs became available here, the government would face daunting distribution problems in a country where health clinics are widely scattered and parts of the population are illiterate or without transportation.

The Pharmaceutical Manufacturers Association of South Africa, which is trying to block South Africa's new drug legislation along with 40 drug companies, welcomed Mbeki's comments yesterday. Mirryena Deeb, the association's executive officer, said an emergency declaration and the disputed law were both unnecessary to fight AIDS.

"A far better alternative would be to forge a partnership with all sectors of government, industry, business, clergy, schools working toward a common purpose," Deeb said.

Eric Goemaere, coordinator for Doctors Without Borders for South Africa, said that yesterday's AIDS debate failed to focus on practical solutions to South Africa's health crisis.

"With all the people dying there is an emergency," he said. But the debate in parliament, he said, seemed a political game between opposition party members and the president.